Doctors adapt to tough conditions

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An Australian medical team is adapting to challenging
conditions as it helps tsunami victims.

Haggard, dehydrated survivors are flooding Indonesia's disaster
zone as the global relief operation to help 5 million people in
tsunami-stricken regions faces new challenges.

Helicopters ferrying survivors to medical help in Banda Aceh
faced another bottleneck, this time of their own creation -
overcrowded hospitals.

About a dozen people lay on stretchers on the footpath outside
Fakina Hospital in Banda Aceh, a provincial capital on Indonesia's
hard-hit Sumatra island. Many of the hospital's rooms had no power.
Walls were flecked with blood and doctors had run out of stands for
intravenous fluid bags, hanging them from cords across the
ceiling.

"We'd like some surgical instruments, some surgical gowns and
some masks, because we still have none of them. We need the gowns
because that's what protects us."

Dr Sharwood is a member of the 28-strong Australian team that
has spent the past week working in the only two hospitals in Banda
Aceh that are still able to treat the massive number of
injuries.

It was the first time Australia has sent such a civilian
surgical team offshore in an emergency, and the anaesthetist
responsible for logistics, Dr Ken Harrison, said it was not
possible to get these items before the Australian Government jet
took off from Richmond air base.

When they arrived in Banda Aceh, they found problems they had
not expected. There was no one to help them unload 18 tonnes of
equipment so they did it themselves with a couple of members of the
NSW Fire Brigade and the aircraft crew.

"The physical work was a massive effort," said Dr Harrison. "Now
we call ourselves the doctors and stackers union."

Then there were no beds at the airport, but the fire brigade had
tents which they all slept in while they waited to get to town.

They discovered another problem, the cries of patients treated
by the Indonesian colleagues who, Dr Alan Garner from Careflight
said were "not keen on anaesthetics".

The doctors are treating a lot of massive fractures and
infections, a result they say, of the equivalent of immersion in a
washing machine full of bricks, trees and polluted water.

There were no critical care patients; they had already died by
the time the Australians arrived last Thursday. Instead they have
done a lot of amputations to deal with advanced infections.

While children who survived devastation along the Indian Ocean
were already receiving makeshift help to cope with the
psychological trauma of losing relatives, aid agencies warned that
they and other victims would need special attention.

In a psychiatric ward at Karapitiya hospital in the Sri Lankan
city of Galle, an area hammered by the tsunami, some patients
banged their heads against the wall. Some, wide-eyed, just stared
vacantly, while others mumbled "the sea is coming".

They were among the first in Galle to be treated for
post-traumatic stress disorder, doctors said.